Research o­n a suitable health economics management model for Vietnam

Pham Huy Dung

Place of publication: Health strategy and policy institute

Year of publication: 1998

Objective: Evaluate economic functional structure in health care provision in order to build up a model of macro- and microeconomics integration to approximate the health economic model and to increase management quality, effectiveness and equity in health care.

Methods: Micro- and macrocosmic analysis of health finance before and after the renovation.

Results: Macrocosmic analysis: The government budget consists of two parts: the basic and the regular budget and is divided into two levels: central and local. The government budget is always an important source of finance to maintain all the health activities from the central to the commune levels. Microcosmic analysis: Hospital fee and health insurance are the main sources of income for hospital activities. The proportion of hospital fee in the hospitals of big cities is higher than the government budget, even higher than regular expenses. The approximate model was built based o­n the balance correlation of funding, provision and services use. The applied model for district health centre is the model of finance management integration. The main feature of the model is the realisation of a joint fund in the context of building the health centre o­n the basis of the health department and the district hospital and management transfer from the district people's committee to the health department.

Recommendation: A new model of economic management needs to be developed with the balance of the relationships among the three sectors: finance, provision and organisation; The government budget should be changed from subsidy for providers to subsidy for users in order to increase the productivity, quality and attitude of the providers; It is necessary to calculate the unit costs of health services, identify the cost components for the convenience of collecting partial charges when necessary; It is necessary to develop health insurance, reinforce the current health insurance and develop new health insurance models; Diversified economic management is considered and developed in the context of renovation of the health system in Vietnam in general.